BURDEN OF SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) EXACERBATIONS IN ENGLAND: THE COPD SEVERE EXACERBATIONS (COVERS) REAL-WORLD EVIDENCE STUDY
Author(s)
Bethany Levick, PhD1, Parul Dayal, MS, PhD2, Luca Le Treust, MSc1, Shea O'Connell, PhD1, Manminder Kaur, PhD3, Jennifer Quint, PhD4, Nikola Jovanoski, PhD5, Johannes Ammann, BSc, MS, PhD5, Ajay Patel, MSc3.
1OPEN Health, London, United Kingdom, 2Genentech Inc., South San Francisco, CA, USA, 3Roche Products Ltd, Welwyn Garden City, United Kingdom, 4School of Public Health, Imperial College, London, United Kingdom, 5F. Hoffmann-La Roche Ltd, Basel, Switzerland.
1OPEN Health, London, United Kingdom, 2Genentech Inc., South San Francisco, CA, USA, 3Roche Products Ltd, Welwyn Garden City, United Kingdom, 4School of Public Health, Imperial College, London, United Kingdom, 5F. Hoffmann-La Roche Ltd, Basel, Switzerland.
OBJECTIVES: Despite the high clinical impact of severe COPD exacerbations, real-world data regarding patients requiring inpatient admission remain scarce. This study aimed to provide a better understanding of characteristics and healthcare resource utilisation of patients with severe exacerbations.
METHODS: This was an observational cohort study based on the Hospital Episode Statistics database, linked to Office for National Statistics death registration database, and included patients (≥40 years) hospitalised (non-elective admission ≥1 day) for a COPD exacerbation from January 2021-December 2023 in England. Follow-up was defined as time from index date to end of observation period (December 2024) or death.
RESULTS: 155,597 patients were included (mean age [standard deviation], 73.1 [10.9] years; female, 54.0%; Charlson comorbidity index 2 and 3+, 8.9% and 53.0%, respectively; most frequent comorbidities: congestive heart failure [29.8%], renal disease [22.3%]). By index of multiple deprivation quintile (Q), 30.9% of patients were in Q1 (most deprived), 22.6% in Q2, 18.4% in Q3, 14.9% in Q4 and 11.2% in Q5 (least deprived). Overall, 96,280 severe exacerbation events were recorded; the crude incidence of subsequent exacerbations was 366.5 (95% CI, 364.2-368.8) per 1,000 person-years of follow-up. The mean length of stay for index admission was 6.3 days. Thirty-day all-cause readmission occurred in 18.8%; 3.2% had COPD-related readmissions. 81.2% had ≥1 readmission at any time during follow-up (mean total length of stay, 30.8 days). During follow-up, all-cause mortality reached 46.8%, with cumulative incidences of 28.5%, 42.3% and 52.9% at 1, 2 and 3 years, respectively. Median overall survival was 2.7 years (95% CI, 2.67-2.73).
CONCLUSIONS: In England, severe exacerbations, observed in a greater percentage of patients living in socio-economic deprivation, place a substantial burden on healthcare providers and patients, particularly regarding length of hospital stay, subsequent readmissions and survival outcomes. The results emphasise the need for more efficient treatment in this patient population.
METHODS: This was an observational cohort study based on the Hospital Episode Statistics database, linked to Office for National Statistics death registration database, and included patients (≥40 years) hospitalised (non-elective admission ≥1 day) for a COPD exacerbation from January 2021-December 2023 in England. Follow-up was defined as time from index date to end of observation period (December 2024) or death.
RESULTS: 155,597 patients were included (mean age [standard deviation], 73.1 [10.9] years; female, 54.0%; Charlson comorbidity index 2 and 3+, 8.9% and 53.0%, respectively; most frequent comorbidities: congestive heart failure [29.8%], renal disease [22.3%]). By index of multiple deprivation quintile (Q), 30.9% of patients were in Q1 (most deprived), 22.6% in Q2, 18.4% in Q3, 14.9% in Q4 and 11.2% in Q5 (least deprived). Overall, 96,280 severe exacerbation events were recorded; the crude incidence of subsequent exacerbations was 366.5 (95% CI, 364.2-368.8) per 1,000 person-years of follow-up. The mean length of stay for index admission was 6.3 days. Thirty-day all-cause readmission occurred in 18.8%; 3.2% had COPD-related readmissions. 81.2% had ≥1 readmission at any time during follow-up (mean total length of stay, 30.8 days). During follow-up, all-cause mortality reached 46.8%, with cumulative incidences of 28.5%, 42.3% and 52.9% at 1, 2 and 3 years, respectively. Median overall survival was 2.7 years (95% CI, 2.67-2.73).
CONCLUSIONS: In England, severe exacerbations, observed in a greater percentage of patients living in socio-economic deprivation, place a substantial burden on healthcare providers and patients, particularly regarding length of hospital stay, subsequent readmissions and survival outcomes. The results emphasise the need for more efficient treatment in this patient population.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD108
Topic
Epidemiology & Public Health, Health Technology Assessment, Real World Data & Information Systems
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)